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If you are starting the think you might be depressed, or that your brain is out to kill you, here’s what you do…

The following is an “unrolled” Twitter feed from Mark Reid, MD on depression. It’s solid, important advice that I thought should be shared. Dr. Reid is an internist from Denver, who is very active on Twitter as @medicalaxioms. He is also the author of Medical Axioms, a delightful book of medical wisdom

If you are starting the think you might be depressed, or that your brain is out to kill you, here’s what you do:

1. Find or call your primary care IM of family MD. When you call for an appointment and they ask what for, say “depression.” Notice how the scheduler doesn’t flinch. They get this call 4 times a day!

2. When you get to the doctor, and they ask what’s wrong, just say, “I want you to do those screening tools on me to see if I’m depressed.” Let them do their thing. If they say you’ve got it, let them tell you how meds and counseling work. Let them tell you what they know about pills and which one might help you. Decide together if pills are worth a shot. Tablets really work for some people.

3. You also need a counselor. Ask the MD for a referral. That might work. If not,

4. Go to your insurance and find out their preferred providers for counseling. I suggest you pick someone your same gender. Counterintuitive for some but works better for many.

5. If that doesn’t work, go in the internet and type in counselor or therapist and the name of your town or city. Read ratings and reviews. Cross reference them with yelp. Look for someone nearby who writes a bio that sounds okay. Figure you’ll see them once a week and it will cost $100. Give them 4 tries. If you don’t feel like you are getting anywhere, ditch them and try again. I’ve seen 3 people in the last 10 years and in retrospect I can rank them.

6. With tablets and shrinks, the trick is resolve. If they aren’t working or give side effects, don’t just quit. Try again. Different shrink. Go back and try a different tablet with your MD.

You can feel better and you are worth it. You deserve it.

There’s lots of other stuff that helps some people: support groups, sobriety, exercise, sleep hygiene, self help books, spiritual practice, ALANON. If your shrink is any good they will recommend this stuff and know something about it.

Depression is a disease, not a failing. You wouldn’t judge yourself for a sprained ankle. This is the same…. except for one thing. The disease of depression includes not being able to objectively see what’s going on. That’s why it’s so important to get started on treatment.

If you are a medical student or resident, counseling is available for you and it’s free. The same rules hold, though. If the first person you see isn’t helping after 3 or 4 visits, it’s ok to make an appointment with someone else. This is not personal and you don’t have to worry about “hurting their feelings” any other consequences.

The National Suicide hotline is 1-800-273-8255. You are loved. You matter. This is a disease not a failure. Please seek help.